Abstract: A system for dynamic stabilization of the spine includes a bone engaging fastener configured to be anchored in a vertebra and a deflectable element mounted on the fastener. The deflectable element or bumper is configured and arranged to contact a portion of an adjacent vertebra, such as the facet, during extension of the spine, while offering no resistance during flexion. In certain embodiments, a cable may be fastened to the bone engaging fastener and arranged to contact a portion of the adjacent vertebra, such as the spinous process, during flexion of the spine. In one surgical technique of the invention, a contralateral approach is used to introduce the bone engaging fastener through the deflectable element and into the vertebra.

Abstract: A guide sleeve with longitudinally offset bone engaging portions is provided for engagement with anterior-posterior offset vertebral bodies. In one aspect of the invention the guide tube has fixed bone engaging portions in a predetermined offset position. In another form of the invention, the guide sleeve is composed of at least two moveably connected portions adapted to permit adjustment of the offset between the bone engaging portions. Further, a method is provided for using a guide sleeve with offset bone engaging portions.